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Excerpt
Methods: At the Hospital for Sick Children, Toronto children with suspected IBD are systematically evaluated with colonoscopy, mucosal biopsies and small bowel radiography. Since 1980 data have been prospectively recorded in an ACCESS database. To approximate a population-based study, analysis was restricted to children age <15 years at diagnosis, and with residential postal code within the GTA. (Neither adult gastroenterologists nor general pediatricians independently manage such young patients in the GTA). Data by decade were compared to an earlier cohort (Hamilton and Bruce 1977). Statistics Canada Census data were utilized to estimate incidence and prevalence.
Results: Based on January 2000 census data, the prevalence of pediatric IBD in the GTA is 17.2 per 100,000. During the past two decades Crohn’s disease (CD) has predominated over ulcerative colitis (UC) (ratio 13:7). Patient demographic data are summarized in Table 1. The percentage of children in the GTA who are Jewish has been stable at 3.2% to 3.7% during the three decades, whereas the percentage of Northern European Caucasian (NEC) origin has decreased from 74% (1980’s) to 60% (1990’s). 53–59% of Jewish probands have an affected first or second degree relative, in comparison to 18–25% of non-Jewish probands.
Conclusion: Children developing IBD reflect the increasing racial heterogeneity of the GTA. IBD has been consistently more common and strikingly familial in Jewish children. Pediatric CD affects males more often than females. The incidence of pediatric onset UC has remained stable over three decades, while that of CD has increased almost 3-fold. In comparison to CD, UC is recognized in children at a younger age; however, the age at recognition of CD has decreased modestly during the recent decade.
